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Patient-centered informed consent in surgical practice.
James L Bernat1, Lynn M Peterson
1Neurology Section, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, 1 Medical Center Drive, Lebanon, NH 03756, USA. bernat@dartmouth.edu
Archives of Surgery (Chicago, Ill. : 1960)
|January 18, 2006
Summary
Informed consent for surgery is an ongoing communication process, not just a signature. Patient-centered medicine emphasizes shared decision-making between patients, surgeons, and surrogates for effective surgical consent.
Area of Science:
- Medical Ethics
- Surgical Practice
- Patient Rights
Background:
- The doctrine of informed consent is fundamental in surgery.
- Challenges arise with incapacitated patients requiring surrogate decision-makers.
- The scope of surgical consent regarding complications requires clarification.
Purpose of the Study:
- To review the medical, ethical, and legal basis of informed consent in surgery.
- To explore the concept of shared decision-making in patient-surgeon relationships.
- To discuss patient-centered approaches to surgical consent and refusal of treatment.
Main Methods:
- Literature review of PubMed, focusing on informed consent, patient-physician communication, and shared decision-making.
- Analysis of guidelines from major surgical and critical care societies.
- Selection and extraction of data from relevant articles on surgical consent.
Main Results:
- Qualitative aspects of the informed consent doctrine were examined.
- Surgical consent is an evolving process, not a singular event.
- Communication is key throughout the patient's surgical journey.
Conclusions:
- Surgical consent is an ongoing dialogue, encompassing preoperative, perioperative, and postoperative phases.
- Patient-centered medicine redefines consent as shared decision-making.
- Effective communication and shared decision-making are crucial for ethical surgical practice.